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News

VA to address inconsistencies in handling disability claims

Chris Adams - Knight Ridder Newspapers

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May 19, 2005 03:00 AM

WASHINGTON—The Department of Veterans Affairs is planning to boost oversight of how its regional offices handle mental disability cases, hoping to reduce the inconsistencies that give some veterans more generous payments than others.

The action comes as the VA's Office of Inspector General released a report that detailed the agency's uneven handling of veterans' claims for disability compensation, which provides 2.5 million veterans with monthly checks for injuries suffered while in the military.

The inspector general sought to explain the wide variations in benefits payments among the VA's regional offices. Annual average award amounts range by state from $6,961 in Illinois to $12,004 in New Mexico.

As part of the effort, a survey found that VA claims handlers consider themselves overworked: 65 percent said there was insufficient staff to "ensure timely and quality service," and 57 percent said it was difficult to meet production standards if they thoroughly reviewed all the evidence in a claim.

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But neither the inspector general nor top VA officials who released the report Thursday could conclusively answer the central question: Why does wide variation exist among states? Instead, they said more study and better data were needed.

The inspector general did say that a host of demographic factors over which the VA has no control was responsible for part of the difference. But he also said that factors the VA does control contributed as well.

Disabled veterans are entitled to payments that range from $108 to $2,299 a month. The VA's 57 regional offices decide the veterans' claims.

The inspector general said the decision on a claim for post-traumatic stress disorder payment is difficult because key information "is not physically apparent and is more susceptible to interpretation and judgment." That, in turn, leads to inconsistent rating decisions, the report said.

Because post-traumatic stress disorder is such a prevalent condition among veterans, those cases go a long way toward explaining the regional variation. A third of the variation among states is eliminated when high post-traumatic stress disorder awards are removed from the analysis, the report said.

The investigation also found a high percentage of errors in the handling of post-traumatic stress disorder cases—and determined that in 25 percent of a sample of cases it reviewed there was "inadequate assurance that benefits were paid properly."

Overall, physical ailments—such as the loss of a limb—have been evaluated consistently, VA officials said. But mental conditions are more open to interpretation.

"We have much to do to make this more consistent among the various regional offices," said Daniel Cooper, who heads the benefits division within the VA and helped announce the findings.

Among other things, the VA will review post-traumatic stress disorder cases nationwide and analyze future decisions to identify unusual patterns. Training will also be standardized.

Beyond that, the agency said it will re-examine recent cases in which veterans were given the highest possible awards for post-traumatic stress disorder. While VA officials said veterans shouldn't worry that their payments will be reduced, the agency said it wants to go back and properly document all such cases.

The report's findings mirror the results of a March Knight Ridder series on the VA's disability compensation program, which found payments for mental ailments are subject to wide swings and veterans in certain states are far more likely to get high post-traumatic stress disorder payments than those in other states. The exclusive Knight Ridder analysis was based on a review of 2.5 million veteran claims records, released only after Knight Ridder sued the VA in federal court last November.

Last summer, Knight Ridder also detailed how veterans in some states—such as Alaska, at 16 percent—are far more likely to be on the VA's compensation rolls than those in others, such as Illinois, at 6 percent.

The inspector general's report was started in December in response to reporting by the Chicago Sun-Times, which detailed the outrage of Illinois veterans and their elected leaders over having low payments.

On Thursday, the VA said the situation in Illinois has improved in recent years and that decisions by the Chicago regional office from 2004 were in line with national averages.

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To read the Knight Ridder investigation of the VA's disability claims process, go to: http://www.realcities.com/mld/krwashington/news/special_packages/veterans/.

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